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Figure 1. Chest X-ray showing widened mediastinum Discussion Ortner’s syndrome, or cardiovocal syndrome, is a clinical condition associated with left recurrent laryngeal nerve palsy due to cardiovascular disease. The palsy arises from compression of the recurrent laryngeal nerve as it passes between the arch of the aorta and the pulmonary artery.1,2 The syndrome was first described in 1897 by Norbert Ortner, an Austrian physician who ascribed hoarseness of voice with left recurrent laryngeal nerve palsy secondary to a dilated left atrium in three patients with mitral valve stenosis.3 It has now been estimated that the incidence of Ortner’